Men's Osteoporosis Support Group

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Another omeprazole fracture risk study

Calcif Tissue Int. 2008 Nov 21. [Epub ahead of print], Increase in Vertebral Fracture Risk in Postmenopausal Women Using Omeprazole. Roux C and others. PMID: 19023510. This is yet another study showing an increased risk of fracture for people taking a proton pump inhibitor (PPI) like omeprazole. This study involved 1,211 postmenopausal women followed for six years with 5% of them taking omeprazole at baseline. Age-adjusted rates for vertebral fractures were 1.89 and 0.60 for 100 person-years for omeprazole users and nonusers, respectively (P = 0.009). Omeprazole use was a significant and independent predictor of vertebral fractures (RR = 3.50, 95% CI 1.14-8.44). The authors conclude, "Omeprazole use is associated with an increased risk of vertebral fractures in postmenopausal women. Further studies are required to determine the mechanism of the association between the underlying gastric disease, omeprazole use, and risk of osteoporotic fractures."

Editor's comments. This is the third recent study I have posted on this site showing increased risk of fracture for individuals taking a PPI. There is a 2008 Update and a 2006 Update covering these two studies. With The Roux and others study showing a 3.5 times increased risk of fracture compared to individuals not taking omeprazole, this appears to be a serious additional fracture risk. The most likely source of the problem from PPIs is the reduction of stomach acid that decreases absorption of calcium. But that hasn't been scientifically proven yet. Whatever the cause, it would behoove people to find a way to reduce acid reflux without taking PPIs.

As I stated in the 2008 Update, I have managed to get myself off omeprazole completely. I outline the steps that I took in that Update, but give no guarantees they will work for everyone. Since writing that Update I have probably taken no more than 5-10 anti-acids for reflux. That was always when eating out and unable to control exactly what I eat. I would add to that list that I feel that vinegar is very much an irritant and cause of acid reflux for me. I have found that avoiding it entirely, either alone or in foods such as pickles, has really helped. I suspect that many of the people taking PPIs could stop or reduce their need for them with all or some of the changes I suggest. But it definitely requires some lifestyle changes. Most likely changing the type and quantity of food eaten, using the wedge-shaped pillow at night, sleeping on the left side, and avoiding anything that you know causes reflux. Good luck, the reward should be a reduced risk of fracture, as well as no more acid reflux. Be sure to check with your care provider before stopping the omeprazole.

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